POSITION TITLE:                         Utilization Coordinator – Home Health

STATUS:                                       Full Time (RF Status – 80 Hours/Pay Period)

DAY/SHIFT/HOURS:                   Monday – Friday, 8am-4:30pm, On Call rotation

Job Profile Summary: 

Oversight of visiting RN’s and HHA, managing patient’s episode care, point of contact for providers and referral sources, fielding patient/provider/caregiver phone calls, ensuring regulatory requirements are satisfied during referral process and episode of care, absorbing overflow of nursing visits as needed.

Responsibilities: 

• Promotes and demonstrates quality and productivity through the completion of assigned duties in an effective manner
• Promotes and demonstrates customer focused care, including patients, physician, referral sources, other departmental staff, and staff within the department
• Assists the director in maintaining positive relationships within the department and with physicians and outside organizations
• Performs direct nursing care functions in the event that field-staffing levels are inadequate to meet the scheduling needs of the department
• Assists with the competency assessment of new and established staff
• Assists with the orientation of new visiting nursing staff 
• Attends and participates in in-services to maintain or enhance technical skills 
• Assists the staff in completing the OASIS assessment in utilizing the data to help develop the patient’s plan of care
• Reviews and updates 485 data in the home health system to complete the initial and recertification orders
• Evaluates the plan of care to determine that it corresponds with the findings on the OASIS and confirms that the plan is appropriate for the patient’s needs, and any required additional services are obtained and ordered
• Visits with the home health staff to complete competency evaluations 
• Reviews orders for appropriateness and completeness prior to printing and submitting to the physician for signature
• Oversees and/or completes ICD coding for admissions and recertification
• Oversee/complete the discharge and transfer process
• Conduct SOC and discharge conference with RN's
• Participates in the department's performance improvement and Infection Prevention activities
• Managerial on call rotation
• Coordinates care for patient's DME and service needs

Education:

• Graduate from an accredited school of professional nursing
• BSN required within 3 years of hire

Certifications:

• Current State Licensed Registered Nurse (RN)
• Basic Life Support (BLS) through American Heart Association (AHA).
• OASIS Certification preferred

Work Experience:

• Home Health experience required

Physical Requirements:

• Requires standing and walking for extensive periods of time.
• Requires normal or corrected hearing and vision to normal range.
• Sedentary work exerting up to 10 pounds of force occasionally. Sedentary work involves sitting most of the time. 
• Perform repetitive tasks/motions

Complexity of Work:

• Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision.
• Must be able to work in a stressful environment and take appropriate action.

Personal Protective Equipment:

• Follows standard precautions using personal protective equipment as required.